Claim Raven explanation
What this means
This rule addresses evaluation of the sacroiliac region, where the spine meets the pelvis. It directs VA to consider the lumbosacral and sacroiliac joints as one anatomical segment for rating purposes.
The section describes imaging and examination findings that may help identify the disability. A location of pain alone is not a complete diagnosis, and overlapping symptoms should be considered with the applicable rating rules.
How this helps your claim
This helps you compare the diagnosis and examination with how VA described the affected region. Look for the evidence explaining the source and functional effects of the symptoms.
What to check in your records
Use your decision, examination reports, and relevant records to check the following points.
- Find imaging and diagnostic findings for the sacroiliac and lumbosacral region.
- Review documented tenderness, spasm, and movement limitations.
- Check how the decision accounted for overlapping symptoms in the same segment.
Connect the pain location with the anatomical findings
Pain near the lower back and pelvis can be described with several overlapping terms. This section directs attention to the lumbosacral and sacroiliac region as an anatomical segment. The examination and imaging help identify what is actually affected.
Keep the diagnosis, movement findings and any distinct neurological effects clear. A new location label does not automatically mean a separate disability evaluation is appropriate. Read the relevant spine or residual criteria with the overlap rules so the same functional effect is not simply counted under another name.
Does sacroiliac pain automatically receive a separate spine rating?
No. The anatomical and rating relationship needs to be evaluated under the applicable provisions. A symptom's location is not enough to establish a separate compensable manifestation. The evidence should identify the condition and any distinct effects before conclusions are drawn about separate evaluations.
Official regulatory text
38 CFR § 4.66
eCFR snapshot: September 3, 2026. Layout and spacing are adapted for reading. The full section and its tables are included below.
§ 4.66 Sacroiliac joint.
The common cause of disability in this region is arthritis, to be identified in the usual manner. The lumbosacral and sacroiliac joints should be considered as one anatomical segment for rating purposes. X-ray changes from arthritis in this location are decrease or obliteration of the joint space, with the appearance of increased bone density of the sacrum and ilium and sharpening of the margins of the joint. Disability is manifest from erector spinae spasm (not accounted for by other pathology), tenderness on deep palpation and percussion over these joints, loss of normal quickness of motion and resiliency, and postural defects often accompanied by limitation of flexion and extension of the hip. Traumatism is a rare cause of disability in this connection, except when superimposed upon congenital defect or upon an existent arthritis; to permit assumption of pure traumatic origin, objective evidence of damage to the joint, and history of trauma sufficiently severe to injure this extremely strong and practically immovable joint is required. There should be careful consideration of lumbosacral sprain, and the various symptoms of pain and paralysis attributable to disease affecting the lumbar vertebrae and the intervertebral disc.
Related references
- 38 CFR § 4.1: What a VA disability rating measures
- 38 CFR § 3.159: VA duty to assist: records and examinations
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